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    Hypothalamic dysfunction

    Hypothalamic dysfunction is a problem with the region of the brain called the hypothalamus, which helps control the pituitary gland and regulate many body functions.

    Causes

    The hypothalamus helps control the pituitary gland, particularly in response to stress. The pituitary, in turn, controls the:

    • Adrenal glands
    • Ovaries
    • Testes
    • Thyroid gland

    The hypothalamus also helps regulate:

    • Body temperature
    • Childbirth
    • Emotions
    • Growth
    • Milk production
    • Salt and water balance
    • Sleep
    • Weight and appetite

    Causes of hypothalamic dysfunction include:

    • Anorexia
    • Bleeding
    • Bulimia
    • Genetic disorders
    • Growths (tumors)
    • Head trauma
    • Infections and swelling (inflammation)
    • Malnutrition
    • Radiation
    • Surgery
    • Too much iron

    The most common tumors in the area are craniopharyngiomas in children.

    Symptoms

    Symptoms are usually due to the hormones that are missing. In children, there may be growth problems -- either too much or too little growth -- or puberty that occurs too early or too late.

    Tumor symptoms:

    • Headaches
    • Loss of vision

    Hypothyroidism symptoms:

    • Cold intolerance
    • Constipation
    • Depressed mood
    • Fatigue
    • Hair or skin changes
    • Hoarseness
    • Impotence
    • Loss of body hair and muscle (in men)
    • Mental slowing
    • Menstrual cycle changes
    • Weight gain

    Low adrenal function symptoms:

    • Dizziness
    • Weakness

    Other, less common symptoms may include:

    • Body temperature problems
    • Emotional problems
    • Excess thirst
    • Obesity
    • Uncontrolled urination

    Kallmann's syndrome (a type of hypothalamic dysfunction that occurs in men) symptoms:

    • Lowered function of sexual hormones (hypogonadism)
    • Inability to smell

    Exams and Tests

    Blood or urine tests to determine levels of hormones such as:

    • Cortisol
    • Estrogen
    • Growth hormone
    • Pituitary hormones
    • Prolactin
    • Testosterone
    • Thyroid

    Other possible tests:

    • Hormone injections followed by timed blood samples
    • MRI or CT scans of the brain
    • Visual field eye exam (if there is a tumor)

    Treatment

    Treatment depends on the cause of the hypothalamic dysfunction.

    • Tumors -- surgery or radiation
    • Hormonal deficiencies -- replace missing hormones

    Specific treatments may be available for bleeding, infection, and other causes.

    Outlook (Prognosis)

    Many causes of hypothalamic dysfunction are treatable. Most of the time missing hormones can be replaced.

    Possible Complications

    Complications of hypothalamic dysfunction depend on the cause.

    Brain tumors:

    • Permanent blindness
    • Problems related to the brain area where the tumor occurs
    • Vision disorders

    Hypothyroidism:

    • Heart problems
    • High cholesterol

    Adrenal insufficiency:

    • Inability to deal with stress (such as surgery or infection), which can be life threatening

    Gonadal deficiency:

    • Heart disease
    • Impotence (in men)
    • Infertility
    • Thin bones (osteoporosis)

    Growth hormone deficiency:

    • High cholesterol
    • Osteoporosis
    • Short stature (in children)
    • Weakness

    When to Contact a Medical Professional

    Call your doctor if you have:

    • Headaches
    • Symptoms of hormone excess or deficiency
    • Vision problems

    Prevention

    Maintain a healthy diet and don't exercise toohard or lose weight too quickly. If you believe you have an eating disorder such as anorexia or bulimia, get medical attention: these conditions can be life threatening.

    If you have symptoms of a hormonal deficiency, discuss replacement therapy with your health care provider.

    References

    Low MJ. Neuroendocrinology. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 7.

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            Review Date: 12/11/2011

            Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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